Journal «Angiology and Vascular Surgery» •
2018 • VOLUME 24 • №4
State of the venous outflow from the small pelvis after surgical correction of pelvioperineal reflux
Gavrilov S.G.1, Karalkin A.V.2, Moskalenko E.P.2, Savinkova K.Yu.1
1) Chair of Faculty Surgery №1, Therapeutic Department, Pirogov Russian National Research Medical University (RNRMU),
2) Municipal Clinical Hospital №1 named after N.I. Pirogov, Moscow, Russia
Objective. The study was aimed at assessing the venous outflow from the small pelvis after surgical correction of pelvioperineal reflux with the use of reference methods of examination.
Patients and methods. We examines a total of 43 female patients (aged 41.5±5.2 years) presenting with pelvic varicose veins and subjected to phlebectomy on the external genitalia, perineum and lower limbs. All women had no evidence of pelvic venous plethora. All women underwent the following examinations: ultrasonographic angioscanning of pelvic and lower-limb veins, emission computed tomography of pelvic veins prior to operation, as well as 1, 6 and 12 months after surgical interventions. We evaluated efficacy of phlebectomy in elimination of pelvioperineal reflux and varicose syndrome, the frequency of detecting valvular insufficiency of pelvic and lower-limb veins, dynamics of the coefficient of pelvic congestion syndrome in the immediate and remote postoperative periods.
Results and discussion. No cases of relapses of valvular, perineal varicosity, repeat appearance of varicose veins on the lower extremities, occurrence of signs of pelvic venous congestion were revealed. The frequency of detecting valvular insufficiency of the parametrial, uterine, gonadal and iliac veins remained unchanged. The coefficient of pelvic congestion syndrome did not alter either (Cpcs=0.8±0.11 at baseline versus Cpcs=0.78±0.1 after 12 months).
Conclusion. The obtained results are indicative of a steady state of the venous outflow from the small pelvis in women with pelvic varicose veins and pelvioperineal reflux after surgical removal of vulvar, perineal and superficial femoral veins.
KEY WORDS: pelvic varicose veins, pelvioperineal reflux, treatment, phlebectomy, venous outflow from the small pelvis, emission computed tomography of pelvic veins.
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